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June 20, 2023 Briefs, Studies

Providing cash-based support to the vulnerable to purchase private health insurance would increase access to quality healthcare at roughly the same per enrollee costs as Medicaid programs - finds the latest paper in the Coverage Denied series released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click to download the brief “Tens of millions are stuck in a flawed government-run healthcare system that provides sub-par care to patients, imposes huge taxpayer costs, and harms the...

January 4, 2023 Briefs, Studies

DOWNLOAD THE BRIEF   Executive Summary Declining productivity growth in the delivery of healthcare is not innate to the sector. It simply reflects the current policy environment. Incentivizing a more productive and cost-effective healthcare provider sector is possible but requires comprehensive policy reforms that eliminate the obstacles blocking progress. These reforms include: Implementing the insurance reforms discussed in Part 5 that, from a provider perspective, will incentivize the creation of innovative payment models. New payment models create opportunities to better align the incentives...

November 16, 2022 Briefs, Price and Costs, Studies

SACRAMENTO – The broken 340B program, designed to provide affordable care for at-risk patients, creates massive profits for providers without necessarily improving patient health outcomes and should be reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click here to download a copy of the brief “The 340B program is growing unsustainably and isn’t improving health outcomes for at-risk patients,” said Dr. Wayne Winegarden, the Center’s director and the...

October 10, 2022 Briefs, Price and Costs, Studies

CLICK HERE TO READ THE BRIEF In addition to the reforms to the health insurance system, which will help address the problems of drug affordability, reforms tailored to the pharmaceutical sector are necessary. These reforms should eliminate drug supply chain inefficiencies and include: fostering a patient-controlled generics market, creating price transparency through reforms that ensure patients directly benefit from all discounts when purchasing their medicines,  fixing the drug formularies’ systemic biases against low-cost medicines, and encouraging contracting innovations that could create...

August 22, 2022 Briefs, Industry Trends, Price and Costs, Studies

SACRAMENTO – Biosimilars competition saves patients and the health care system over $11 billion annually and could generate even more savings if the broken drug pricing system were reformed, finds a new issue brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. “Patients living with cancer, autoimmune diseases, osteoporosis, and other illnesses are receiving revolutionary treatment from biologics,” said Dr. Wayne Winegarden, the Center director and the study’s author. “As our research shows,...

July 25, 2022 Briefs, Price and Costs, Studies

CLICK HERE TO READ THE BRIEF Establishing an Efficient Health Insurance Market Cultivating an efficient health insurance market requires reforms that empower patients over payers, which can be achieved by: Making health expenditures and health insurance expenditures tax deductible;  Broadening the availability and usability of tax-free saving accounts to help patients cover the deductibles and out of pocket expenses that could arise should they require costly healthcare services; and Promoting price transparency and insurance competition to enable a more competitive pro-patient healthcare...

May 2, 2022 Issues, Price and Costs, Radio, Resources

Listen to the author of a new study discuss how America’s broken third-party healthcare payment system prioritizes government and insurance companies as the largest payers, leaving patients with higher out-of-pocket costs, greater exposure to healthcare financial risk, and reduced access to care.  To learn more, read the "Coverage Denied" series from PRI's Center for Medical Economics and Innovation. ...

April 28, 2022 Briefs, Price and Costs, Studies

America’s broken third-party healthcare payment system prioritizes government and insurance companies as the largest payers, leaving patients with higher out-of-pocket costs, greater exposure to healthcare financial risk, and reduced access to care - finds the latest paper in the Coverage Denied series released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute. Click here to read the brief “The healthcare marketplace should prioritize the needs of patients, but our broken third-party payment system caters to insurers...

March 1, 2022 Briefs, Policy Proposals, Price and Costs, Studies

READ THE REPORT The problem of drug affordability is caused by the perverse incentives created by the third-party payer system that have disempowered patients in favor of insurers and other supply-chain intermediaries. The insurance flaws have created pricing systems that inequitably transfer a disproportionate share of drug costs on to patients. This arrangement inappropriately imposes a drug affordability problem on patients who require expensive medicines. The insurance flaws also incent benefit design policies that create additional affordability burdens and unnecessarily increase...

February 22, 2022 Issues, Multimedia, Policy Proposals

Watch PRI’s Wayne Winegarden, director of our Center for Medical Economics and Innovation, discuss efforts by the Federal Trade Commission to considering ordering large pharmacy benefits managers to study the competitive impact of contractual provisions, reimbursement adjustments, and other practices affecting drug prices on Scripps National News. https://youtu.be/DQsjKM44ScQ...

January 12, 2022 Briefs, Industry Trends, Price and Costs

BY WAYNE WINEGARDEN AND CELINE BOOKIN Part 1 of the Coverage Denied series documented how distortions in the U.S. healthcare system turned the important financial risk management service of health insurance into a barrier to care and an important driver of health care inflation. The insurance industry’s adverse impact on costs is ironic given its current focus on implementing cost control measures.  Unfortunately, the problems of increasing obstacles to care and decreasing health care affordability are the expected outcomes from the current...

November 3, 2021 Briefs, Price and Costs

Policies that promote biosimilar competition have the potential to save U.S. patients up to $5.8 billion collectively if biosimilars to Humira and Enbrel grow in market share, finds a new brief released today by the Center for Medical Economics and Innovation at the nonpartisan Pacific Research Institute, a California-based, free-market think tank. Click to download “Generating Drug Savings Through Competition” “The significant savings potential that patients and taxpayers alike would realize from introducing biosimilars to Humira and Enbrel to the U.S. market...